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06.06.14

NHS and councils need multi-year funding settlements – LGA

Local Government Association (LGA) chief executive Carolyn Downs has backed NHS Confederation calls for a long-term, multi-year funding settlement for the health service – and said local government should get one too.

Speaking on a panel with care minister Norman Lamb MP at the NHS Confederation annual conference and exhibition yesterday, Downs said: “The next government, whoever they might be, should seriously, seriously consider a longer-term funding settlement for the whole Parliament for both local government and indeed the NHS, which would give us a much longer period over which we will be able to work together and actually pool budgets to get the most cost-efficient and best possible care for people in our communities.”

NHS Confederation chief executive Rob Webster, in his keynote speech on Wednesday, had already suggested a funding settlement of perhaps 10 years. This ‘decade deal’ would “take money off the table”, he said, allowing local leaders the flexibility and freedom to plan properly over the long term.

The Better Care Fund – money for local plans to integrate health and care, developed jointly by health bodies and local authorities – has been a big point of contention at the NHS Confederation conference. Many in the health world, especially within hospitals, see it as an excuse to essentially transfer money from health budgets to struggling local government ones.

The solution, most speakers said, was some kind of transition fund: a one-off pool to allow transformation to happen without suddenly cutting hospital budgets before new systems to deliver care closer to people’s homes and in the community are in place.

Health secretary Jeremy Hunt did not address those arguments in his own keynote speech yesterday, instead just suggesting that other organisations needed to ‘share the risk’ with hospitals. He said: “Any out-of-hospital organisation that’s benefiting from extra resources as a result of the Better Care Fund – on the basis that they’re going to reduce emergency admissions into hospital – must share some of the risk if what they are doing doesn’t in fact reduce emergency admissions.

“By making sure we have a proper risk-sharing profile in all the Better Care Fund plans, we will make sure incentives are properly aligned.”

Speaking earlier in the day, Downs had said: “Throughout the LGA, we are very clear that if this agenda is going to be successful, we do need to have single commissioning and integrated delivery of adult social care and health services.

“The LGA I don’t think has a view specifically on the legal requirement to pool budgets [as suggested by Lamb], but we very much agree that local authorities and indeed the NHS should be encouraged to combine the whole of our budgets.”

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She said that of the £14bn that councils spend on adult social care, “that whole amount of money should be considered as a part of health pooling”.

But she reminded that audience of how hard integration can be even inside organisations – let alone between organisations with different cultures.

Tell us what you think – have your say below or email opinion@nationalhealthexecutive.com

(Images copyright NHS Confederation)

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